多症候性真性多血症に伴う網膜動脈閉塞症の治療

Treatment of central retinal arterial occlusion in polycythemia vera

　37歳男性の真性多血症患者に，左眼網膜中心動脈閉塞症，表在性血栓性静脈炎，下肢動脈閉塞症，肺血栓症および腸間膜血栓症が発症した．網膜動脈閉塞症の治療にウロキナーゼ大量静脈内点滴注入（最大1日量24×10^4U，6日間で総量88.8×10⁴U）および潟血（250ml／日，4日間）が有効であり，左視力は0.04から1.0まで改善した．

A 37-year-old male with polycythemia vera of 4 years' duration developed acute occlusion of the central retinal artery in his left eye, following a transient attack the night before. The patient had been suffering from episodes of superficial thrombo-phlebitis, arterial thrombosis in the extremities, pulmonary infarction and mesenteric thrombosis.

The visual acuity at the initial examination was RE.: 1.5 and L.E. : 0.04 with corrections. The red blood cell count was 688 x 104/mm3. Erythrocyte sedimentation rate was 1 mm /2 h. The patient was treated with intravenous urokinase for 6 consecutive days totalling 88.8 x 10⁴ units and phlebotomy of 250 ml per day for 4 days.

The visual acuity in the left eye improved to 1.0 three months later.